Comparison of HHV-6 DNA detection in plasma and whole blood in allogeneic hematopoietic stem cell transplant recipients: frequent false-positive results for active HHV-6 infection using whole blood samples
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In this prospective observational study, we compared the human herpesvirus-6 (HHV-6) DNA load in serially collected paired plasma and whole blood (WB) samples from allogeneic hematopoietic stem cell transplantation (HSCT) recipients. A total of 721 paired samples were collected from 68 recipients. The positive rate for HHV-6 DNA was 9.7 and 35.0% in plasma and WB samples, respectively (P < 0.001). The correlation of HHV-6 DNA load between plasma and WB was poor (R2 = 0.250). After reaching peak levels, HHV-6 DNA showed a delayed decrease in WB in comparison with plasma (median, 28 versus 7 days, P < 0.001). We additionally tested HHV-6 mRNA status in 95 samples from eight patients. To identify positive HHV-6 mRNA, plasma HHV-6 DNA showed 55.0% sensitivity and 100% specificity, whereas WB HHV-6 DNA showed 90.0% sensitivity and 68.0% specificity. The false-positive rate for identifying positive HHV-6 mRNA was 0% for plasma HHV-6 DNA and 32.0% for WB HHV-6 DNA. Although WB was more sensitive than plasma for detecting HHV-6 reactivation, the rates of false positivity for active HHV-6 infection were higher for WB than for plasma.
KeywordsHuman herpesvirus-6 Plasma Whole blood mRNA Allogeneic hematopoietic stem cell transplant
This work was supported in part by the Japan Society for the Promotion of Science (JSPS) KAKENHI (Grant-in-Aid for Scientific Research) Grant Number JP17K09090.
KT and MO were responsible for the design of the study, interpretation of the data, and writing the manuscript. KT, MO, and YN analyzed the data. Data were collected by KT, MO, and YN. Laboratory work was carried out or supervised by KT, RK, TS, and KS. All authors contributed to the revision of the manuscript and approved the final version. We thank the following individuals for their contributions to this study: Kazuhiro Kohno (Koureiren Tsurumi Hospital) and Natsumi Yoshida (Oita University Faculty of Medicine). We also thank Analisa Avila, ELS, from Edanz Group and Mike Adams for proofreading a draft of this manuscript.
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Conflict of interest
The authors declare that they have no conflict of interest.
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